Impact of PPE Type and Healthcare Worker Characteristics on Quality of Perioperative Communication

ABSTRACT

Introduction: Personal protective equipment (PPE) required for the care of patients with SARS-CoV-2 may impair communication between healthcare providers, increasing the potential for medical error. However, it is unclear how the type of PPE and characteristics of healthcare providers impact communication. Methods: 75 healthcare workers at Memorial Hospital West completed a 19 item survey to qualitatively assess the impact of gender, age, healthcare role (preop nursing, recovery nursing, OR nursing, surgeon, surgery assistant, anesthesia), native language (English, other), respirator type (N95, P100) and eye protection type (face shield, goggles) on employee perception of communication. The Bamford- Kowal-Bench(BKB) sentence list, a benchmarked tool for evaluating comprehension of verbal communication, was utilized to quantitatively analyze communication between representative healthcare workers wearing varying PPE was assessed. Variables in the quantitative analysis included distance between workers (3 versus 6 feet), phone versus in person communication, and ambient noise level (60 dB, 90dB). An Iasus GP3-R throat microphone was evaluated as an intervention to improve communication. Results: In the qualitative survey, the age of the speaker / listener (41-60) and speaker respirator (P100) impacted communication more than other factors (p <0.05). All participants agreed that higher background noise and phone conversations represented additional risks. In the quantitative survey, comprehension scores were lower for speakers wearing a P100 respirator, regardless of eye protection. Noise level reduced comprehension to a greater extent on phone. Distance between speaker and listener did not impact comprehension. Native speakers with P100 were more easily understood than non-native speakers with P100. The use of Iasus GP3-R throat microphone improved comprehension except in the case of non-native speakers wearing a P100 respirator. Conclusions: Communication between workers is impacted by PPE and may contribute to medical error. Comprehension is affected by respirator type, native language of speaker, and age of listener / speaker.